Member Services Representative

Willamette Dental; Hillsboro (OR); On-site; USD 27,552 - 35,817; Full time

Benefits offered by this job

Medical insurance

Dental and vision insurance

Tuition reimbursement

Flexible spending accounts

401(k) with 5% match

AD&D insurance

Life insurance

Voluntary disability insurance

Commuter benefits

Fig scrubs (two pairs)

Job summary

Willamette Dental is seeking a Member Services Representative to handle incoming calls, answer questions about membership eligibility and benefits, and provide clear information about Willamette Dental Group systems and processes.

The role emphasizes courteous communication, problem resolution within scope, and participation in outreach programs. High school diploma and 2 years of customer service in a call center are required; experience communicating benefits to diverse members is preferred.

Qualifications

• Minimum two years of customer service experience in a high-volume call center.
• Experience communicating benefits to a diverse member base preferred.
• Ability to educate members on dental benefits and Willamette Dental Group systems.

Responsibilities

• Respond to member calls, answer questions on eligibility, benefits, claims, and policies.
• Educate members on dental benefits and Willamette Dental Group processes.
• Escalate complex issues to higher authority and coordinate with other teams as needed.
• Support various outreach programs.

Skills

Customer service

Phone support

Communication

Problem solving

Education

High School Diploma or equivalent

Job description

The Member Services Representative communicates with members via incoming calls to efficiently and effectively answer membership questions regarding benefit eligibility, performs outreach communications and handles all inquiries within the scope of the position’s responsibility.

Essential Position Functions

• Respond to Member calls in a courteous and professional manner, answering questions and inquiries regarding membership eligibility, benefits, claims, notice of actions or adverse benefit determinations, grievance processes, policies and procedures. Completes forms and other paperwork as needed, and document all incoming and outgoing calls.
• Educate members on the guidelines of their dental benefits with the company and their insurance partners. Understand and clearly communicate Willamette Dental Group systems, processes, policies and treatment services to members.
• Assess and resolve problems within the scope of authority; escalates complex questions or problems to more experienced representatives or higher authority level.
• Identify complaints and understand how to facilitate the process with the Practice or Member Services Grievance, Appeal and Care Coordination.
• Supports various outreach programs

Education & Experience

High School Diploma or equivalent and two years of customer service experience in a high volume call center; or any equivalent combination of education and/or experience which leads to the ability to perform the essential functions of the position. Experience in communicating benefits to members with diverse backgrounds and cultures preferred.

Expected hourly hiring range for this position depending on experience:

$20 - $26 USD

Compensation

The actual base pay offered to the successful candidate will be based on multiple factors, including but not limited to education, job-related knowledge/skills, experience, geographical location, and internal equity.

This position is also eligible for incentive pay in accordance with the terms of the Company’s plan.

Company Benefits

Willamette Dental offers the following benefits for this position, subject to applicable eligibility requirements:

• medical
• dental and vision insurance
• tuition reimbursement
• flexible spending accounts
• 401(k) retirement plan with 5% match
• accidental death and dismemberment insurance
• life insurance
• voluntary disability insurance
• commuter benefits
• two complimentary pairs of Fig scrubs (clinical roles)
• employee assistance program

Paid Time Off (PTO): Eligible employees will accrue a minimum of 120 PTO hours per employment year in addition to seven paid holidays annually. The Company’s PTO program combines vacation and sick leave, which is more generous than Washington State’s Sick Leave Law. Employees in part-time roles working less than 40 hours per week will accrue PTO on a pro-rated basis.

Physical Requirements

The work is primarily performed while sitting and/or standing, but will require occasional walking, bending, stooping and carrying light items such as papers, books, or other supplies. The incumbent uses a computer and other standard office equipment to complete tasks.

Willamette Dental is an equal opportunity employer.

We provide equal employment opportunities to all employees and applicants for employment without regard to an individual’s race (including physical characteristics historically associated with race), religion, color, age, sex (including pregnancy), national origin, veteran status, disability, marital status, genetic information, sexual orientation, gender identity, pregnancy-related condition, or any other classification protected by applicable federal, state or local laws.

This job description is not meant to be an all-inclusive list of duties and responsibilities, but constitutes a general definition of the position’s scope and function in the company.

This position may be exposed to PHI in the course of his/her duties, and will handle protected information (PHI) in a manner consistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).